Accidents, injuries, recovery methods and avoidance

This thread has been inspired by Iain's updates on his daily training, and his avoidance of things that might aggravate his current injury.

I've had a number of training injuries over the years, and I'm certain I'm not alone. I thought it would be interesting to create a 'lessons learned' thread - where we could get reminders of 'what not to do' to improve our training safety, and also the advice as to how best to train with an injury, to help it recover quickly, and (if any) the benefit gained from the injury.

I'll start with a minor avoidable injury I gained about 20 years ago. At the time I was a young confident brown belt, and particularly confident in my Fudo Dachi. So confident I asked a junior kyu grade to try and sweep me. The resulting full power shin roundhouse kick to the side of my knee was not what I had in mind. It didn't move me (in fact the kicker ended up on his back holding his shin) but it did crack the head of my fibula, which made moving very painful for some time. My training solution was to devote lots of time to slow stance transitions to work the joint. The lesson learned? Always make sure both people in a paired training situation know the exact parameters of the training to be followed. :)

Major injuries? Not a training injury - but something that had a profound affect on my training. I've had two kidney transplants and been on Continuous Ambulatory Peritoneal Dialysis twice http://en.wikipedia.org/wiki/Peritoneal_dialysis for some time while waiting for the transplants. That's posed a few issues. In the first place training following major abdominal surgery is interesting (these days inserting and removing a CAPD catheter is keyhole work - for both of mine I had a 5 inch incision from the naval down (and slightly larger abdominal incisions for the transplants) - you never realise just how continuously you use abdominal muscles until they are cut! In the second place training with a tube sticking out of your abdomen can cause complications. Finally training while anaemic and weak does affect performance and motivation.

Firstly I'd say I was lucky. When I first edged towards dialysis I became too anaemic to carry on with Karate classes and switched to home training, but while on dialysis I had an Aikido teacher who allowed me to continue despite having tubes hanging out of me. I think he accepted that the physical risk of injury in training was lower than the potential psychological injuries in such circumstances of not being able to carry on.

But overall - what did I learn? I learned that even if it is painful, it is better to adopt the correct posture asap rather than hunching over and letting things heal incorrectly. I learned that slow training not only continues to work strength, balance and stamina, but also allows greater evaluation of performance that refines technique. I learned (in my weaker state), that positioning and technique made a huge difference when strength and speed were no longer so available. I think the injuries and the recovery process gave me a greater insight into the importance of good biomechanics. Finally I learned that if you believe in yourself and commit the effort, you can succeed in your goals.

Thanks for kicking off what I think will be a really useful tread. Like most here I’ve had innumerable minor injuries and a handful of major ones. All were no fun at all and hampered training and life in general. Here are a few thoughts on injuries in general:

Prevention is better than cure: When I look back on the majority of the injuries I’ve had, the cause could be traced back to a failure of safety precautions. This is generally due to myself or training partners failing to discharge our duties effectively. I popped my left knee because my partner forced a throw when my foot had got stuck against the mat as I resisted; I split my thumb in two (lengthways) because I did not breakfall correctly and bounced onto my own thumb; I tore my shoulder because I was pushing a heavy lift without a suitable spotter; etc. Risks need to be assessed and precautions taken in preparation and in training to minimise the risk of injury.

The picture to the right was taken when I’d popped my knee in September 2004 (cameras on mobiles weren’t as good back then hence the poor quality of the picture). Notice the gas bottle on the floor to numb the pain before moving me to the ambulance. In case you were wondering it was Murray who took all the photos … he’s a good friend ;-)

We should train for injury prevention: I think that the stronger bones, ligaments and tendons that have resulted from decades of weight lifting have definitely helped me to avoid injuries in martial training. I also think the stretching to keep muscles loose and pliable has also prevented pulls and tears in the rough and tumble of martial training.

We need to push ourselves; not destroy ourselves: The bottom line is that if we do what we can already do then there is no progress. So we need to go beyond what we can do, but not so far beyond that point that injury is inevitable. We train most effectively when we move just outside our current limits. Trying to do what is way beyond us in a rush to improve is counterproductive and will result in injury.

When we get an injury, we should take the advice of the experts: Whenever I’ve injured myself, everyone and his dog has a theory about what it is and what is needed to fix it. While well meaning, I strongly feel we should take our advice from those with the medical training to give it. If such expert advice does not fit with what we are experiencing or does not help, then by all means seek a second opinion. However, sticking with the experts is far safer than going with what a mate “who had the same thing” says.

Don’t get addicted to the injury: This one always confuses me, but I know loads of people who love being injured! They seem to like the “lifestyle” and love nothing more that endless visits to the physiotherapist. I would guess this comes from a subconscious association with professional sports people who also spend a lot of time injured i.e. “elite athletes spend a lot of time injured, so if I do too then I’m just like them!” The bottom line is that if you are going for “treatment” for a very long period of time, you might what to consider that that treatment isn’t working? The aim is not to live with injury, but get beyond it. As I say, I don’t fully get this one, but enjoying being injured and the all that goes with it can’t be healthy.

Keep a positive mindset: I can’t count the number of times that people have told me that a given injury is sign to quit training hard or quit training completely. I’m only 40 and have many years of hard training ahead of me! Be realistic, take the time to heal and follow the advice of the experts as you recover; but don’t write yourself off and indulge yourself with lots of self-pity. Very few injuries are “career ending” and a negative mindset can sometimes cause more damage to your training than the injury itself.

Don’t stop training completely but find ways to work around your injury: When I popped my knee I could not kick for a full 12 months. I could however work on the stationary bike (which actually helped the knee and I was advised to do), do my upper body weights, and, once the knee was strong enough to move around on, I could punch. When I busted the thumb, I had my hand in plaster for months so I could not spar, do kata at speed, lift weights, etc. I could, however, work my stances, kick, run, etc. When totally out, I can still read, research, teach, visualise, etc. Progress can still be made in other areas and it’s a common mistake to drop everything when there is normally other ways to train and progress. Be creative!

Give yourself time to heal: Don’t “test injuries out” too soon. Keep working around it and still give it some time after the pain has gone in order to be certain things are healed. Also start gentle and don’t jump back into the deep end. Many injuries are made long term through bad management of the injury.

Learn from your injury: What caused the injury to happen? Work out what and then adjust your training, thinking, routine, whatever, to avoid a repeat of the injury in the future.

I’m sure others will have more to add, but the above are some of the key things I’ve found useful in avoiding injury, getting over injury and ensuring consistent progress. Should be a very interesting and useful thread!

I, too, have had a number of injuries. I've done my adductor muscles in both legs, done something nasty to my shoulder whilst doing the overhead press, had an aoperation on the cartilidge in my right knee, but the most irritating is one I discovered last Saturday. I'm not sure if it qualifies as an injury, per se, but I discovered, after knee X-rays, that I have arthritis coming on in my right knee. The upshot is that I have to stop running, but the cycling, the weight-training and the karate should all be okay as long as I am careful. My doctor said 'never forget that you have a knee'. I take this to mean that with something of this magnitude, you need to always be aware of the fact that you are no compromised, in a certain way, which I think is something that we all need to do. If we are weakened in a particular way, we need to be able to adjust our training in a way to favour the injured part and to not make it worse.

I am now considering how I can continue with the karate in such a way as to not leave me with pain and a disability in 10 years. If anyone has any advice, it would be welcomed. I'm ONLY 41, for God's sake :o

I have my first serious injury in my 45 years of karate.Why because I didn t listen to what my body was telling me.In december after a heavy biceps shoulder workout during the day karate at nightI injuried my elbow.It got better after acouple of days.Happened again in January same Scenrio.Than March after a heavy chest back workout during the day I went to class in St Catherines Ont at night and during Rendori I could feel myelbow go again I continued as I was having so much success with blocking with my back hand and striking at the same time with my front I continued for several more matches..We had a break got back on the floor and did Kihon which had me throwing aleft jab first one ow second one ouch third one I am done.Changed went home the wife knew there was something wrong when I came home an hour early and coat over my shoulder no shirt in 20 C temperatures. Next day I was suppose to go in on nights in avery phyisically demanding job and told them I wasnt making it in .Went to emergency and the doctor said I was done for 10 to 14 .An ultrasound latter showed two suggnificant tares in atendon in the back of my shoulder.9 weeks latter elbows better shoulder not still waiting to get in to see aspecialist (In Canada I will be lucky to be back to work this year) still training at home trying out a southpaw stance l as I have no high block to protect my face from my left havent worked since (Thank god for our union and the disability insurance).Started back to class taeching and working lightly and relearning alot of the old Kitagawa katas my instructor use to teach.So I guess my advice is Train smart and listen to what your body is telling you.

I had a motorcycle accident when I was 16 and broke my left kneecap in half. The surgeon who put it back together suggested I avoided running more than anything because of the impact damage it causes and cycling or swimming being the preferred way to get the muscle build back on the leg without causing further injury to the joint. The other thing I am careful with is not to over load the knee to much when cycling or doing Karate. Other than I can do everything everyone else is doing in class.

Some very useful advice their Iain. Thanks for posting it. Thanks too John for starting this thread.

I am (currently and maybe not much longer) a member of a club that has a high focus on tournaments. Many of the people I train with are half my age and 3-4 times as fast as me. About a year ago I learned a valuable lesson, not as the result of being injured myself but hurting someone I was sparring.

He was about 20 and very fast. I threw a jodan tzuki which he attempted to deflect, but because he was so fast he had completed the deflection before my hand had actually gotten there so he missed completely. My fist proceeded to bounce off his nose and the claret started to flow. As daft as it sounds, he had forgotten that you need to adjust the speed of your movements to that of your partner.

Not much more I can add but some advice I would give is to properly recover after illness before training again.

A few years back I had a pretty bad virus of some sort that put me on my back for a week. Probably flu or something.

I was eager to get back to training but ended up slipping a disc training some Judo throws (and still get some sciatic pain from it). I think I went back while still weakened and tried to train at a level my body just couldn't cope with.

It's not a race to get back to training...take your time and make sure you do it right.

I haven't contributed to this forum before, so i thought I'd share some experiences...

Apart from the 'routine' bruises and strains I suffered a major wrist break about 2 years ago which was amplified by a previous break (damn skateboards). I would love to impress you all by saying that i broke it performing a 6ft back flipping kick or deflecting a round house kick from a 16 stone kick boxer.... no, I broke it doing shuttle runs... Don't laugh. I was giving 110% (as usual) and as I sprinted towards the mirrored wall for the last leg I somehow managed to slide just before i tagged the wall, bang! I very quickly realised how stupid I'd been and how easily it could have been avoided.

After 2 major operations (and planning a third) it’s only just started to get into a useful state. The first surgeon told me that my martial arts would be 'out of the question' which worried me somewhat. The physiotherapist was a little more positive stating the injury would only be as 'good as you are prepared to make it'. Not being easily defeated, I set about doing every task the physiotherapist set me. I was then transferred over to a specialist after and this surgeon was much more supportive. He told me to 'listen to your body - it will tell you when it’s had enough'. I pushed every exercise (as recommended) even though most were painful and very uncomfortable. I can honestly say that the years of hard training helped me through this process; I guess you get used to feel of aching muscles.

The result is that I have gained almost full strength back in my left wrist. It's by no means perfect, I have limited movement in certain directions and it doesn't look to pretty. I guess I could turnover and start doing something easier or less risky... but we only have one life, so live it. I could get run over by a bus tomorrow (or so they say).

So what have i learned from this rather painful experience:

1) Don't listen to everything a doctor tells you, if you think they may be wrong, get a second opinion.

2) My break was initially repaired by our local hospital by a surgeon that deals with 'standard breaks'. My break was complex and had I gone to a 'specialist' in the first instance they could have done a much better job. I was only transferred to the royal derby hospital (that has a hand & wrist specialist) after the second operation. If it looks bad, question whether you can go to a hospital that deals with your type of injury.

4) Listen carefully to what exercises you should be doing and ask for more.... i did and it helped.

5) Physiotherapy maybe painful, live with it... it will get better.

6) Stay positive, set small achievable targets... don't rush it.

7) Don't be afraid to tell fellow students about your injury, its better they know what to avoid.

8) Put your ego to bed... Running flat out at a wall is not sensible, if it looks dangerous, it probably is. Ease off rather than put yourself at risk.

Finally... Please don't run wall to wall when performing shuttle runs, just touch the floor (goes without saying really), I squirm every time I hear the thud!

Iain, if this rings any bell's you’re not going insane. You did meet me a few weeks ago at your Birmingham seminar (Big Dave.... or better known as duff man to the Facebook crowd).

When we get an injury, we should take the advice of the experts: Whenever I’ve injured myself, everyone and his dog has a theory about what it is and what is needed to fix it. While well meaning, I strongly feel we should take our advice from those with the medical training to give it. If such expert advice does not fit with what we are experiencing or does not help, then by all means seek a second opinion. However, sticking with the experts is far safer than going with what a mate “who had the same thing” says

Declaration time. I'm a Nurse. I started in Trauma and Orthopaedics and so treated people having had surgery for a myriad of injuries including nasty sports injuries. In latter years I've worked a Minor Injuries Unit thereby being the first point of treatment for pretty much any injury you can imagine and many you can't. Footballers keep me employed. This year I've qualified as an Emergency Nurse Practitioner which has re-invigorated my career and my love of my job. By definintion, I'm an "expert."

Admission time: I've been guilty in the past of giving advice based on information presented over the internet or telephone. This is good practice by me and I strongly recommend no-one actually following advice given in this way. There is no substitiute for a health care professional actually getting their hands on you. Often diagnoses aren't simple, clues in your examination lead you to an "impression" and via testing and interview to a diagnosis. I need to feel the injury for heat, laxity, tension and other factors. Yes, there are simple injuries requiring routine advice but there are also many more subtle injuries or acute (sudden and new) injuries on top of chronic (existing or longer term) injuries.

Advice changes: not so long ago all leg injuries got double tubigrip which to be fair often feels good. However, we now know that for 95% of injuries, this at best does nothing and at worst slows down healing. Yet I still get people coming into my department with double tubigrip on. Current research is suggesting (but certainly isn't conclusive yet) that Ibuprofen is a bad thing for injury healing. This is why you need to go and see an expert. We are obligated to keep out knowledge up to date. Your Coach may very well have been very good and very knowledgeable ten years ago but I've seen massive changes in recommended treatments in that time.

I hope this helps. I would add that standard first aid has changed little and in the first instance, you can't go far wrong with ice and elevation.

I saw this thread and since the OP has had kidney probs, i thought I would add mine.

I am sat at home with a 10-15 inch incision on my left side of my body, just under the rib cage. i had a 3.5cm cyst on top of the kidney which they thought might be cancer and so they removed at least 1/2 of my kidney about 12 days ago to get rid of the cyst.

I fully understand now how much I used my stomach muscles as I am still struggling to get out of bed/settee. I was supposed to go for my 2nd Dan this december but that is now on hold till next year. i actually got an infection when i was in hospital and a collapsed lung during the operation, which makes me very breathless when I talk a lot at the moment.

I wanted to know how people thought about going back to sparring eventually. To be honest its a small part of my karate these days as I prefer kata,basics, and I also teach a lot now, etc than rather the sparring aspect and also it depends on who I have to spar as you cant trust the other person not to hit that side and sometimes I think I could get an accidental hit there which would mean losing the rest of my kidney.

Am I being too worried about the kidney that is left. I do know that the other kidney has problems with it too and I dont really want to lose either of them since it was quite a painful surgery!!!!

On another note - i had a arthroscopy on my left knee some 11 years ago now where I was told that I had a knee of a 60 year old, I was only 27 at the time. This did make me give my karate up for 6 years till I moved to austraila where I now do karate but with braces on both knees to stop them from trwisting and poping out.

Mayeb my body is telling me something!!!! Telling me to live next the beach and relax for the next 30-40 years. HA i am only 38 now. The age is what is bothering me as I am quite young and i dont want to be in and out of hospital just because i wanted to sparr adn got myself injured.

I am sat at home with a 10-15 inch incision on my left side of my body, just under the rib cage...I fully understand now how much I used my stomach muscles as I am still struggling to get out of bed/settee.

Iain made the point on one Podcast that some injuries can almost be a "blessing" because they force you out of your routine, allow you to rest a part of your body and cause you to develop others. This is a mindset that I promote. Fractured ankle? Work your upper body. Wrist in a cast? Kick (with care because the cast will affect your balance).

Abdominal injuries are the exception. This is almost nothing that you do with your body that doesn't involve use of abdominal and lumbar spine muscles. Injuries such as yours, hysterectomies, appendicectomies and so on are just incredibly debilitating.

Just thought of another incident and it's very pertinent to how a class is organised.

During one Hapkido grading we started with rolling breakfalls. It wasn't set up very well and me and a mate ended up rolling towards each other. As we both came up out of our breakfall we clashed heads with a sickenng thud.

I felt my head and as I looked down into my hands they filled with blood. I had a 2 inch gash across one eyebrow that bled like crazy. Some quality suturing and you can barely see a scar.

My mate however had a tiny nick in the centre of his forehead that barely bled. BUT when he got home later that evening he collapsed with a delayed concussion and ended up in hospital.

Things I/we can draw from this is to be very aware of how people are moving and in what direction. Make sure they aren't going at cross purposes. Have some qualified first aiders on hand (and a kit with plasters in it). Take into account the after effects as they may not be apparent at first.

Things I/we can draw from this is to be very aware of how people are moving and in what direction. Make sure they aren't going at cross purposes. Have some qualified first aiders on hand (and a kit with plasters in it). Take into account the after effects as they may not be apparent at first.

And TAKE HEAD INJURIES VERY SERIOUSLY.

I could regale you with stories of head injuries all day. The advice that I would give is that if you vomit, see "stars" or flashing lights, have a headache that won't go away, have any degree of amnesia, neck pain or pain at the opposing point of the impact (even in the absence of anything else I've mentioned) then FFS get yourself off to A&E ASAP or call 999.